Deck 48: Care of Surgical Patients

Question 1

The nurse is caring for a postoperative patient on the medical-surgical floor.To prevent venous stasis and the formation of thrombus after general anaesthesia,what does the nurse encourage the patient to do?

A)Coughing.
B)Diaphragmatic breathing.
C)Incentive spirometry.
D)Leg exercises.

Answer 1

Leg exercises.

Question 2

The nurse is caring for a postoperative patient with an abdominal incision.A pillow is used during coughing to provide which of the following?

A)Pain relief.
B)Splinting.
C)Distraction.
D)Anxiety reduction.

Answer 2

Splinting.

Question 3

An obese patient admitted for abdominal surgery is more susceptible to the postoperative complication of which of the following?

A)Anemia.
B)Seizures.
C)Protein loss.
D)Dehiscence.

Answer 3

Dehiscence.

Question 4

The nurse is serving as preceptor for a student nurse and explains that perioperative nursing care occurs when or where?

A)Before,during,and after surgery.
B)In preadmission testing.
C)During the surgical procedure.
D)In the postanaesthesia care unit (PACU).

Question 5

The nurse is caring for a preoperative patient.The nurse teaches the principles and demonstrates leg exercises for the patient.The patient is unable to perform leg exercises correctly.What is the nurse's best next step?

A)Assess for the presence of anxiety,pain,or fatigue.
B)Ask the patient why he does not want to do the exercises.
C)Encourage the patient to practise at a later date.
D)Assess the educational methods used to educate the patient.

Question 6

The nurse and the unregulated care provider are helping a postoperative patient turn in the bed.To assist in minimizing discomfort,which instruction should the nurse provide to the patient?

A)"Close your eyes and think about something pleasant."
B)"Hold your breath and count to three."
C)"Hold my shoulders with your hands."
D)"Place your hand over your incision."

Question 7

Which nursing assessment would indicate that the patient is performing diaphragmatic breathing correctly?

A)Hands placed on border of rib cage with fingers extended will touch as chest wall contracts.
B)Hands placed on chest wall with fingers extended will separate as chest wall contracts.
C)The patient will feel upward movement of the diaphragm during inspiration.
D)The patient will feel downward movement of the diaphragm during expiration.

Question 8

The nurse is caring for a patient in the PACU.The patient has developed profuse bleeding from the surgical site,and the surgeon has determined the need to return to the operative area.This procedure would be classified as which of the following?

A)Elective.
B)Urgent.
C)Emergency.
D)Major.

Question 9

The nurse is providing preoperative teaching for the ambulatory surgical patient who will have a cyst removed from the right arm.Which would be the best explanation for diet progression after surgery?

A)"Start with clear liquids,soup,and crackers.Advance to a normal diet as you tolerate."
B)"There is no limitation on your diet.You can have whatever you want."
C)"Stay on clear liquids for 24 hours.Then you can progress to a normal diet."
D)"Start with clear liquids for 2 hours,then full liquids for 2 hours.Then progress to a normal diet."

Question 10

The nurse is preparing a patient for surgery.Aims of assessment before surgery include which of the following?

A)Establishing a patient's baseline of normal function.
B)Planning for care after the procedure.
C)Educating the patient and family about the procedure.
D)Gathering appropriate equipment for the patient's needs.

Question 11

The nurse is encouraging a reluctant postoperative patient to deep breathe and cough.What explanation can the nurse provide that may encourage the patient to cough more effectively?

A)"If you don't deep breathe and cough,you will get pneumonia."
B)"Deep breathing and coughing will clear out the anaesthesia."
C)"Coughing will not harm the incision if done correctly."
D)"You will need to cough only a few times during this shift."

Question 12

The nurse is caring for a patient in preadmission testing.The patient has been assigned a physical status classification of PS-III by the American Society of Anesthesiologists.Which of the following assessments would support this classification?

A)Denial of any major illnesses or conditions.
B)Normal,healthy patient.
C)History of hypertension,36 kg (80 pounds)overweight,history of asthma.
D)History of myocardial infarction that limits activity.

Question 13

The nurse is encouraging the postoperative patient to utilize diaphragmatic breathing.Reasons for this intervention include which of the following?

A)Management of pain.
B)Decreased healing time.
C)Prevention of atelectasis.
D)Decreased thrombus formation.

Question 14

The nurse is caring for a potential surgical patient in the preadmission testing unit.The medication history indicates that the patient is currently taking warfarin (Coumadin).Which of the following actions should the nurse take?

A)Consult with the physician regarding a radiological examination of the chest.
B)Consult with the physician regarding an international normalized ratio (INR).
C)Consult with the physician regarding blood urea nitrogen (BUN).
D)Consult with the physician regarding a complete blood count (CBC).

Question 15

The nurse is caring for a patient who is scheduled to undergo a surgical procedure.The nurse is completing an assessment and reviews the patient's laboratory test results and allergies.In which perioperative nursing phase would this work be completed?

A)Perioperative.
B)Preoperative.
C)Intraoperative.
D)Postoperative.

Question 16

The nurse is documenting a medication history for the surgical patient in preadmission testing.Which of the following medications should the nurse instruct the patient to withhold in preparation for surgery?

A)Ibuprofen.
B)Acetaminophen.
C)Vitamin C.
D)Miconazole.

Question 17

The nurse is making a preoperative education appointment with a patient.The patient asks whether he should bring family with him to the appointment.What is the best response by the nurse?

A)"There is no need for an additional person at the appointment."
B)"Your family can come and wait with you in the waiting room."
C)"We recommend including family in this appointment to ease everyone's anxiety."
D)"It is required that you have a family member at this appointment."

Question 18

The nurse is caring for a patient in the PACU who has undergone a left total knee arthroplasty.The anaesthesia provider has indicated that the patient received a left femoral peripheral nerve block.Which assessment would be an expected finding for a patient with this type of regional block?

A)Decreased pulse at the left posterior tibia.
B)Left toes cool to touch and slightly cyanotic.
C)Sensation decreased in the left leg.
D)Patient report of pain in the left foot.

Question 19

The patient has arrived at the ambulatory surgery centre for a colonoscopy.The patient is scheduled to receive moderate sedation (conscious sedation)during the procedure.Moderate sedation is used routinely for procedures that require which of the following?

A)An outpatient setting.
B)A depressed level of consciousness.
C)Loss of sensation in an area of the body.
D)Immobility of the patient.

Question 20

The nurse explains the pain relief measures available after surgery during preoperative teaching for a surgical patient.Which of the following comments from the patient indicates the need for additional education on this topic?

A)"I will take the pain medication as the physician prescribes it."
B)"I will be asked to rate my pain on a pain scale."
C)"I will have minimal pain because of the anaesthesia."
D)"I will take my pain medications before doing postoperative exercises."

Question 21

The nurse is preparing a patient for a surgical procedure on the right great toe.Which of the following actions would be most important to include in this patient's preparation?

A)Ascertain that the surgical site has been correctly marked.
B)Ascertain where the family will be located during the procedure.
C)Place the patient in a clean surgical gown.
D)Ask the patient to remove all hairpins and cosmetics.

Question 22

The nurse has completed a preoperative assessment for a patient about to undergo surgery and gathers assessment data.Of the following,which would be the most important next step?

A)Notify the operating suite that the patient has a latex allergy.
B)Document that the patient had a bath at home this morning.
C)Ask the nursing assistant to obtain vital signs.
D)Administer the ordered preoperative intravenous antibiotic.

Question 23

The nurse is preparing for a patient who will undergo surgery.The nurse screens for risk factors that can increase a person's risks in surgery.What risk factors are included in the nurse's screening? (Select all that apply. )

A)Age.
B)Nutrition.
C)Race.
D)Obesity.
E)Pregnancy.
F)Ambulatory surgery.

Question 24

The nurse is reviewing the surgical consent with the patient during preoperative education.The patient indicates that he does not understand what procedure will be completed.What is the nurse's best next step?

A)Notify the physician about the patient's question.
B)Explain the procedure that will be completed.
C)Ask the patient to sign the form.
D)Continue with preoperative education.

Question 25

The nurse is caring for an ambulatory surgical patient.To be discharged home,which criteria must the patient meet? (Select all that apply. )

A)Able to drink fluids.
B)Able to eat crackers.
C)Manageable pain.
D)Able to void.
E)Dry and intact dressing.
F)Able to dress self.

Question 26

The nurse is caring for a postoperative patient who has undergone a carpal tunnel repair.The patient has a temperature of 36.1°C and is shivering.Which of the following is the best reason for this condition?

A)The patient is dressed only in a gown.
B)Anaesthesia lowers metabolism.
C)The surgical suite has laminar flow.
D)The open body cavity contributed to heat loss.

Question 27

The nurse is caring for a patient in the operating suite.Which of the following outcomes would be most appropriate for this patient?

A)At the end of the intraoperative phase,the patient will be free of burns at the grounding pad.
B)At the end of the intraoperative phase,the patient will be free of infection.
C)At the end of the intraoperative phase,the patient will be free of nausea and vomiting.
D)At the end of the intraoperative phase,the patient will be free of pain.

Question 28

The nurse is caring for a patient in the operating suite.The nurse assists in positioning the patient for what reasons? (Select all that apply. )

A)To obtain access to the operative site.
B)To sustain adequate circulatory and respiratory function.
C)To ensure patient safety and skin integrity.
D)To support the use of equipment.
E)To maintain neuromuscular structures.
F)To provide warmth and comfort.

Question 29

The nurse is providing preoperative education and reviews with the patient what it will be like to be in the surgical environment.What points should the nurse include? (Select all that apply. )

A)The surgical area is cold but warm blankets will be provided.
B)The surgical staff will be dressed in special clothing with hats and masks.
C)The operative suite will be very dark.
D)Families are not allowed in the operating suite.
E)The operating table or bed will be comfortable and soft.
F)The nurses will be there to assist you through this process.

Question 30

The ambulatory surgical nurse calls to check on the patient at home the morning after surgery.The patient is reporting continued nausea and vomiting.Which of the following discharge education points should be reviewed with the patient?

A)Instruct the patient to take deep breaths.
B)Instruct the patient to drink ginger ale and eat crackers.
C)Instruct the patient to call the physician and attempt to connect the patient with the physician.
D)Instruct the patient to go to the emergency department.

Question 31

The nurse is caring for a patient in the PACU.The patient asks for a bedpan and states to the nurse,"I feel like I need to go to the bathroom,but I can't." Which of the following nursing interventions would be most appropriate?

A)Encourage the patient to wait a minute and try again.
B)Call the physician and obtain an order for catheterization.
C)Assess the patient's intake and the patient for bladder distension.
D)Inform the patient that everyone feels this way after surgery.

Question 32

The nurse is caring for a patient intraoperatively.Primary roles of the circulating nurse include which of the following?

A)Establishing and implementing the plan of care.
B)Maintaining a sterile field.
C)Assisting with applying sterile drapes.
D)Handing sterile instruments and supplies to the surgeon.

Question 33

During preoperative assessment for a 0730-hour case,the patient indicates to the nurse that he had a cup of coffee at 0700 hours.The nurse reports this information to the anaesthesia provider,anticipating what?

A)A delay in or cancellation of surgery.
B)Questions regarding components of the coffee.
C)Additional questions about why the patient had coffee.
D)Instructions to determine what education was provided in the preoperative visit.

Question 34

The nurse is caring for a patient in the operating suite who is exhibiting tachypnea,tachycardia,premature ventricular contractions,and muscle rigidity.The nurse suspects which condition in this patient?

A)Hypoxia.
B)Malignant hyperthermia.
C)Fluid imbalance.
D)Hemorrhage.

Question 35

The nurse is caring for a patient in the preoperative holding area of an ambulatory surgery centre.Which nursing action would be most appropriate for this area?

A)Monitor vital signs every 15 minutes.
B)Empty the urinary drainage bag.
C)Apply a warm blanket.
D)Check the surgical dressing.

Question 36

The nurse is monitoring a patient in the PACU for postoperative fluid and electrolyte imbalance.Which of the following actions would be most appropriate for this patient?

A)Encouraging copious amounts of water.
B)Weighing the patient and comparing with preoperative weight.
C)Measuring and recording all intake and output.
D)Starting an additional intravenous (IV)line.

Question 37

An appendectomy is appropriately documented by the nurse as which type of surgery?

A)Diagnostic surgery.
B)Palliative surgery.
C)Ablative surgery.
D)Reconstructive surgery.

Question 38

The nurse is caring for a postoperative patient with a history of obstructive sleep apnea.The nurse monitors for which of the following?

A)Choking and noisy,irregular respirations.
B)Shallow respirations.
C)Moaning and reports of pain.
D)Disorientation.

Question 39

The nurse is serving as precept for a new nurse in the perioperative area.The nurse explains that perioperative nursing is based on certain principles and includes which of the following? (Select all that apply. )

A)Purchasing the correct equipment.
B)Providing high-quality and patient safety-focused care.
C)Scheduling the right types of patients.
D)Conducting multidisciplinary teamwork.
E)Ensuring effective therapeutic communication.
F)Providing advocacy for the patient.